Computational approach for identifying immunogenic epitopes and optimizing peptide vaccine through in-silico cloning against Mycoplasma genitalium

Mycoplasma genitalium is a pathogenic microorganism linked to a variety of severe health conditions including ovarian cancer, prostate cancer, HIV transmission, and sexually transmitted diseases. A more effective approach to address the challenges posed by this pathogen, given its high antibiotic resistance rates, could be the development of a peptide vaccine. In this study, we used experimentally validated 13 membrane proteins and their immunogenicity to identify suitable vaccine candidates. Thus, based on immunogenic properties and high conservation among other Mycoplasma genitalium sub-strains, the P110 surface protein is considered for further investigation. Later on, we identified T-cell epitopes and B-cell epitopes from the P110 protein to construct a multiepitope-based vaccine. As a result, the 'NIAPISFSFTPFTAA' T-cell epitope and 'KVKYESSGSNNISFDS' B-cell epitope have shown 99.53% and 87.50% population coverage along with 100% conservancy among the subspecies, and both epitopes were found to be non-allergenic. Furthermore, focusing on molecular docking analysis showed the lowest binding energy for MHC-I (-137.5 kcal/mol) and MHC-II (-183.3 kcal/mol), leading to a satisfactory binding strength between the T-cell epitopes and the MHC molecules. However, the constructed multiepitope vaccine (MEV) consisting of 54 amino acids demonstrates favorable characteristics for a vaccine candidate, including a theoretical pI of 4.25 with a scaled solubility of 0.812 and high antigenicity probabilities. Additionally, structural analyses reveal that the MEV displays substantial alpha helices and extended strands, vital for its immunogenicity. Molecular docking with the human Toll-like receptors TLR1/2 heterodimer shows strong binding affinity, reinforcing its potential to elicit an immune response. Our immune simulation analysis demonstrates immune memory development and robust immunity, while codon adaptation suggests optimal expression in E. coli using the pET-28a(+) vector. These findings collectively highlight the MEV's potential as a valuable vaccine candidate against M. genitalium.

Immune Checkpoint Inhibitors in Geriatric Oncology

PURPOSE OF REVIEW

This manuscript will update prior reviews of immune checkpoint inhibitors (ICIs) in light of basic science, translational, and clinical discoveries in the field of cancer immunology and aging.

RECENT FINDINGS

ICIs have led to significant advancements in the treatment of cancer. Landmark trials of ICIs have cited the efficacy and toxicity experienced by older patients, but most trials are not specifically designed to address outcomes in older patients. Underlying mechanisms of aging, like cellular senescence, affect the immune system and may ultimately alter the host's response to ICIs. Validated tools are currently used to identify older adults who may be at greater risk of developing complications from their cancer treatment. We review changes in the aging immune system that may alter responses to ICIs, report outcomes and toxicities in older adults from recent ICI clinical trials, and discuss clinical tools specific to older patients with cancer.

Multicomponent PFAS sorption and desorption in common commercial adsorbents: Kinetics, isotherm, adsorbent dose, pH, and index ion and ionic strength effects

The adsorption and desorption of 9 PFAS, including 3 perfluoroalkyl sulphonic and 6 perfluoroalkyl carboxylic acids, in artificial groundwater was investigated using 3 commercial adsorbents that comprised a powdered activated carbon (PAC), a surface-modified organoclay (NMC+n), and a carbonaceous organic amendment (ROAC). Sorption kinetics and isotherms of PFAS, as well as the effects of adsorbent dose, pH, index ion and ionic strength on PFAS adsorption and desorption were investigated. Sorption of multicomponent PFAS in the adsorbents was rapid, especially for NMC+n and ROAC, regardless of PFAS chain length. The sorption and (and especially) desorption of PFAS in the adsorbents was impacted by the pH, index ion, and ionic strength of simulated groundwater, especially for the short chain PFAS, with only minimal impacts on NMC+n and PAC compared to ROAC. Although the potential mineral and charged constituents of the adsorbents contributed to the adsorption of short chain PFAS through electrostatic interactions, these interactions were susceptible to variable groundwater chemistry. Hydrophobic interactions also played a major role in facilitating and increasing PFAS sorption, especially in adsorbents with aliphatic functional groups. The desorption of PFAS from the adsorbents was below 8 % when the aqueous phase was deionised water, with no measurable desorption for NMC+n. In contrast, the desorption of short chain PFAS in simulated groundwater increased substantially (30-100 %) in the adsorbents, especially in ROAC and NMC+n, but more so with ROAC. In general, the three adsorbents exhibited strong stability for the long chain PFAS, especially the perfluoroalkyl sulphonic acids, with minimal to no sorption reversibility under different pH and ionic composition of simulated groundwater. This study highlights the importance of understanding not only the sorption of PFAS in groundwater using adsorbents, but also the desorption of PFAS, which may be useful for decision making during the ex-situ and in-situ treatment of PFAS-contaminated groundwater.

Molecular Biomarker Identification Using a Network-Based Bioinformatics Approach That Links COVID-19 With Smoking

The COVID-19 coronavirus, which primarily affects the lungs, is the source of the disease known as SARS-CoV-2. According to "Smoking and COVID-19: a scoping review," about 32% of smokers had a severe case of COVID-19 pneumonia at their admission time and 15% of non-smokers had this case of COVID-19 pneumonia. We were able to determine which genes were expressed differently in each group by comparing the expression of gene transcriptomic datasets of COVID-19 patients, smokers, and healthy controls. In all, 37 dysregulated genes are common in COVID-19 patients and smokers, according to our analysis. We have applied all important methods namely protein-protein interaction, hub-protein interaction, drug-protein interaction, tf-gene interaction, and gene-MiRNA interaction of bioinformatics to analyze to understand deeply the connection between both smoking and COVID-19 severity. We have also analyzed Pathways and Gene Ontology where 5 significant signaling pathways were validated with previous literature. Also, we verified 7 hub-proteins, and finally, we validated a total of 7 drugs with the previous study.

Exploring the anti-cancer potential of dietary phytochemicals for the patients with breast cancer: A comprehensive review

BACKGROUND

The most common and deadly cancer in female is breast cancer (BC) and new incidence and deaths related to this cancer are rising.

AIMS

Several issues, that is, high cost, toxicity, allergic reactions, less efficacy, multidrug resistance, and the economic cost of conventional anti-cancer therapies, has prompted scientists to discover innovative approaches and new chemo-preventive agents.

MATERIALS

Numerous studies are being conducted on plant-based and dietary phytochemicals to discover new-fangled and more advanced therapeutic approaches for BC management.

RESULT

We have identified that natural compounds modulated many molecular mechanisms and cellular phenomena, including apoptosis, cell cycle progression, cell proliferation, angiogenesis and metastasis, up-regulation of tumor-suppressive genes, and down-regulation of oncogenes, modulation of hypoxia, mammosphere formation, onco-inflammation, enzymatic regulation, and epigenetic modifications in BC. We found that a number of signaling networks and their components such as PI3K/Akt/mTOR, MMP-2 and 9, Wnt/-catenin, PARP, MAPK, NF-κB, Caspase-3/8/9, Bax, Bcl2, Smad4, Notch1, STAT3, Nrf2, and ROS signaling can be regulated in cancer cells by phytochemicals. They induce up-regulation of tumor inhibitor microRNAs, which have been highlighted as a key player for ani-BC treatments followed by phytochemical supplementation.

CONCLUSION

Therefore, this collection offers a sound foundation for further investigation into phytochemicals as a potential route for the development of anti-cancer drugs in treating patients with BC.

Bioinformatics and network biology approach to identifying type 2 diabetes genes and pathways that influence the progression of breast cancer

Breast cancer is the second most prevalent malignancy affecting women. Postmenopausal women breast tumor is one of the top causes of death in women, accounting for 23% of cancer cases. Type 2 diabetes, a worldwide pandemic, has been connected to a heightened risk of several malignancies, although its association with breast cancer is still uncertain. In comparison to non-diabetic women, women with T2DM had a 23% elevated likelihood of developing breast cancer. It is difficult to determine causative or genetic susceptibility that connect T2DM and breast cancer. We created a large-scale network-based quantitative approach employing unbiased methods to discover abnormally amplified genes in both T2DM and breast cancer, to solve these issues. We performed transcriptome analysis to uncover identical genetic biomarkers and pathways to clarify the connection between T2DM and breast cancer patients. In this study, two RNA-seq datasets (GSE103001 and GSE86468) from the Gene Expression Omnibus (GEO) are used to identify mutually differentially expressed genes (DEGs) for breast cancer and T2DM, as well as common pathways and prospective medicines. Firstly, 45 shared genes (30 upregulated and 15 downregulated) between T2D and breast cancer were detected. We employed gene ontology and pathway enrichment to characterize prevalent DEGs' molecular processes and signal transduction pathways and observed that T2DM has certain connections to the progression of breast cancer. Using several computational and statistical approaches, we created a protein-protein interactions (PPI) network and revealed hub genes. These hub genes can be potential biomarkers, which may also lead to new therapeutic strategies for investigated diseases. We conducted TF-gene interactions, gene-microRNA interactions, protein-drug interactions, and gene-disease associations to find potential connections between T2DM and breast cancer pathologies. We assume that the potential drugs that emerged from this study could be useful therapeutic values. Researchers, doctors, biotechnologists, and many others may benefit from this research.

Ultrasound-enhanced Magnéli phase Ti4O7 anodic oxidation of per- and polyfluoroalkyl substances (PFAS) towards remediation of aqueous film forming foams (AFFF)

Per-and polyfluoroalkyl substances (PFAS) remediation is still a challenge. In this study, we propose a hybrid system that combines electrochemical treatment with ultrasound irradiation, aiming for an enhanced degradation of PFAS. Equipped with a titanium suboxide (Ti₄O₇) anode, the electrochemical cell is able to remove perfluorooctanoic acid (PFOA) effectively. Under the optimal conditions (50 mA/cm² current density, 0.15 M Na₂SO₄ supporting electrolyte, and stainless steel/Ti₄O₇/stainless steel electrode configuration with a gap of ∼10 mm), the electrochemical process achieves ∼100 % PFOA removal and 43 % defluorination after 6 h. Applying ultrasound irradiation (130 kHz) alone offers a limited PFOA removal, with 33 % PFOA removal and 5.5 % defluorination. When the electrochemical process is combined with ultrasound irradiation, we observe a significant improvement in the remediation performance, with ∼100 % PFOA removal and 63.5 % defluorination, higher than the sum of 48.5 % (43 % achieved by the electrochemical process, plus 5.5 % by the ultrasound irradiation), implying synergistic removal/oxidation effects. The hybrid system also consistently shows the synergistic defluorination during degradation of other PFAS and the PFAS constituents in aqueous film forming foam (AFFF). We attribute the synergistic effect to an activated/cleaned electrode surface, improved mass transfer, and enhanced production of radicals.

Thermal kinetics of PFAS and precursors in soil: Experiment and surface simulation in temperature-time plane

Per- and polyfluoroalkyl substances (PFAS) are chemically and thermally stable due to the presence of carbon-fluorine (C-F) bond in their molecular structures, hence have been previously formulated as firefighting ingredients. During the firefighting process, however, owing to the high temperature, PFAS can be potentially degraded, particularly for PFAS precursors that contain non-C-F bonds, which is studied herein by exposing PFAS-contaminated soil in a muffle furnace oven. Different temperatures and time intervals are applied to the real soil sample to mimic the firing process and to evaluate the degradation and conversion of PFAS. This thermal treatment can not only degrade precursors (e.g. 6:2 fluorotelomer sulphonate), but also degrade perfluoroalkyl carboxylates (PFCA, e.g. perfluorooctanoic acid PFOA) and perfluoroalkyl sulfonates (PFSA, e.g. perfluorooctane sulfonate PFOS). The concentration dependence of the PFAS on temperature and time is fitted using a 2D Gaussian surface to simulate the complex thermal kinetic, and to compare with the traditional approach such as thermogravimetric analysis (TGA) (1D dependence on temperature only). The 2D simulation can directly visualise the thermal kinetic of individual or sum PFAS in the complex temperature-time plane, which depends on the sample background and particularly on the coexist PFAS precursors. Overall, this study provides a simple approach to monitor and optimise the thermal treatment of the PFAS-contaminated soil.

Distribution, sources, and pollution levels of toxic metal(loid)s in an urban river (Ichamati), Bangladesh using SOM and PMF modeling with GIS tool

Indexical assessment coupled with a self-organizing map (SOM) and positive matrix factorization (PMF) modeling of toxic metal(loid)s in sediment and water of the aquatic environment provides valuable information from the environmental management perspective. However, in northwest Bangladesh, indexical and modeling assessments of toxic metal(loid)s in surface water and sediment are still rare. Toxic metal(loid)s were measured in sediment and surface water from an urban polluted river (Ichamati) in northwest Bangladesh using an atomic absorption spectrophotometer to assess distribution, pollution levels, sources, and potential environmental risks to the aquatic environment. The mean concentrations (mg/kg) of metal(loid)s in water are as follows: Fe (871) > Mn (382) > Cr (72.4) > Zn (34.2) > Co (20.8) > Pb (17.6) > Ni (16.7) > Ag (14.9) > As (9.0) > Cu (5.63) > Cd (2.65), while in sediment, the concentration follows the order, Fe (18,725) > Mn (551) > Zn (213) > Cu (47.6) > Cr (30.2) > Ni (24.2) > Pb (23.8) > Co (9.61) > As (8.23) > Cd (0.80) > Ag (0.60). All metal concentrations were within standard guideline values except for Cr and Pb for water and Cd, Zn, Cu, Pb, and As for sediment. The outcomes of eco-environmental indices, including contamination and enrichment factors and geo-accumulation index, differed spatially, indicating that most of the sediment sites were moderately to highly polluted by Cd, Zn, and As. Cd and Zn content can trigger ecological risks. The positive matrix factorization (PMF) model recognized three probable sources of sediment, i.e., natural source (49.39%), industrial pollution (19.72%), and agricultural source (30.92%), and three possible sources of water, i.e., geogenic source (45.41%), industrial pollution (22.88%), and industrial point source (31.72%), respectively. SOM analysis identified four spatial patterns, e.g., Fe-Mn-Ag, Cd-Cu, Cr-Pb-As-Ni, and Zn-Co in water and three patterns, e.g., Mn-Co-Ni-Cr, Cd-Cu-Pb-Zn, and As-Fe-Ag in sediment. The spatial distribution of entropy water quality index values shows that the southwestern area possesses "poor" quality water. Overall, the levels of metal(loid) pollution in the investigated river surpassed a critical threshold, which might have serious consequences for the river's aquatic biota and human health in the long run.

Bioinformatics approach to analyse COVID-19 biomarkers accountable for generation of intracranial aneurysm in COVID-19 patients

COVID-19 became a health emergency on January 30, 2020. SARS-CoV-2 is the causative agent of the coronavirus disease known as COVID-19 and can develop cardiometabolic and neurological disorders. Intracranial aneurysm (IA) is considered the most significant reason for hemorrhagic stroke,and it accounts for approximately 85% of all subarachnoid hemorrhages (SAH). Retinoid signaling abnormalities may explain COVID-19's pathogenesis with inhibition of AEH2, from which COVID-19 infection may enhance aneurysm formation and rupture due to abrupt blood pressure changes, endothelial cell injury, and systemic inflammation. The objective of this study was to investigate the potential biomarkers, differentially expressed genes (DEGs), and metabolic pathways associated with both COVID-19 and intracranial aneurysm (IA) using simulation databases like DIsGeNET. The purpose was to confirm prior findings and gain a comprehensive understanding of the underlying mechanisms that contribute to the development of these conditions. We combined the regulated genes to describe intracranial aneurysm formation in COVID-19. To determine DEGs in COVID-19 and IA patient tissues, we compared gene expression transcriptomic datasets from healthy and diseased individuals. There were 41 differentially expressed genes (DEGs) shared by both the COVID-19 and IA datasets (27 up-regulated genes and 14 down-regulated genes). Using protein-protein interaction analysis, we were able to identify hub proteins (C3, NCR1, IL10RA, OXTR, RSAD2, CD38, IL10RB, MX1, IL10, GFAP, IFIT3, XAF1, USP18, OASL, IFI6, EPSTI1, CMPK2, and ISG15), which were not described as key proteins for both COVID-19 and IA before. We also used Gene Ontology analysis (6 significant ontologies were validated), Pathway analysis (the top 20 were validated), TF-Gene interaction analysis, Gene miRNA analysis, and Drug-Protein interaction analysis methods to comprehend the extensive connection between COVID-19 and IA. In Drug-Protein interaction analysis, we have gotten the following three drugs: LLL-3348, CRx139, and AV41 against IL10 which was both common for COVID-19 and IA disease. Our study with different cabalistic methods has showed the interaction between the proteins and pathways with drug analysis which may direct further treatment development for certain diseases.

Role of Environmental Sustainability, Psychological and Managerial Supports for Determining Bankers' Green Banking Usage Behavior: An Integrated Framework

Purpose

Green banking, an ethical banking concept, concentrates on environmental protection and encourages social and environmental sustainability, perceived cognitive efforts, and subjective norms ensuring ecologically responsive banking services. Consequently, although there have been considerable green banking attempts in Bangladesh, it is yet unknown how environmental sustainability, perceived cognitive effort, and subjective norms affect usage behavior. The present research aims to uncover this gap, extending the Theory of Reasoned Action (TRA) to examine the determinants of the bankers' green banking usage behavior during COVID-19.

Methods

Data were collected from 366 bankers in Bangladesh using a purposive sampling technique and analyzed with structural equation modeling (SEM) using SMART PLS 3 software.

Findings

The study found management support (0.291, t-statistics = 1.978, p 0.000), environmental sustainability (β = 0.278, t-statistics = 2.752, p < 0.001), perceived cognitive efforts (β = 0.401, t-statistics = 3.549, p < 0.000), and subjective norms (β = 0.309, t-statistics = 4.352, p < 0.000) influence bankers' attitudes. Whereas environmental sustainability (β = 0.503, t-statistics = 3.726, p < 0.001), perceived cognitive efforts (β = 0.103, t-statistics = 2.020, p < 0.002), subjective norms (β = 0.281, t-statistics = 4.607, p < 0.000), and attitudes (= 0.602, t-statistics = 5.523, p 0.015) influence bankers' green banking usage behavior. Finally, the mediating role of management supports, environmental sustainability, cognitive efforts and subjective norms on green banking usage behavior through attitudes was significant.

Contribution/Conclusion

The study contributed to existing literature validating the proposed holistic framework applying TRA and three contemporary dimensions explaining bankers' behavior toward green banking practice. Finally, the implementers should focus on green banking practices as green banking is one of the key strategies to protect the environment, assure social justice, and create economic success.

Assessment of microplastics and nanoplastics released from a chopping board using Raman imaging in combination with three algorithms

As contaminants of emerging concern, microplastics and nanoplastics are ubiquitous in not only aquatic and terrestrial environments but also household settings. While the characterisation of microplastics is still a challenge, the analysis of nanoplastics is even more difficult. In this study, we aim to examine several novel algorithmic methods intended for analysing complex Raman spectrum matrices towards visualisation of plastic particles released from a chopping board. Specifically, we compare and advance three decoding algorithms, including (i) a logic-based algorithm to merge and cross-check multiple Raman images that map the intensities of several characteristic peaks; (ii) a principal component analysis-based algorithm to generate intensity images from whole sets of spectra, not just from individual characteristic peaks; (iii) an algebra-based algorithm to merge and cross-check the loading matrix to enhance characterisation efficiency. Assisted with a scanning electron microscope, we estimate that 100-300 microplastics / nanoplastics per mm per cut along the groove formed on the chopping board, and ~3000 per mm² per cut in the scratched area, may be released from a chopping board during food preparation and may be subsequently ingested by human. Overall, the Raman imaging combined with algorithms can provide effective characterisation of microplastics and nanoplastics.

Antecedents of students’ e-learning continuance intention during COVID-19: An empirical study

This study aims at exploring the underlying determinants influencing students' continuance intention to use an e-Learning platform during the COVID-19 pandemic. Based on the technology acceptance model and expectation-confirmation model, the study investigated the role of contextual (i.e., social isolation), psychological (academic year loss and cyberchondria), and student support-related (government and institutional supports) determinants on students' continuance intention to use an e-Learning platform during the pandemic. The study collected data from 440 respondents and analyzed those with Structural Equation Modeling. The findings showed that an e-Learning continuance intention during the pandemic is affected by usefulness, ease of use, attitudes, and intention to use the e-Learning platform; while the behavioral intention is influenced by usefulness, ease of use, attitudes, contextual, psychological, and student support-related determinants; and attitudes are impacted by usefulness and ease of use. Moreover, usefulness is predicted by confirmation of expectation; e-satisfaction is forecasted by usefulness and confirmation of expectation; whereas, cyberchondria is influenced by social isolation; fear of academic year loss is influenced by cyberchondria. Finally, intention to use mediated the impact of usefulness, ease of use, attitudes, contextual, psychological, and student support-related determinants on continuance intention. The study contributes to e-Learning literature incorporating contextual, psychological, and student support-related determinants into the technology acceptance model and expectation-confirmation model, which guide policymakers to understand how all levels of students can be brought into the e-Learning platforms that eventually help to eliminate digital discrimination barrier in the academia during any emergency. The policymakers must be careful in designing eLearning platforms since students' e-learning continuance intention may vary due to unprecedented crises, such as COVID-19.

Raman imaging of microplastics and nanoplastics generated by cutting PVC pipe

The characterisation of nanoplastics is much more difficult than that of microplastics. Herewith we employ Raman imaging to capture and visualise nanoplastics and microplastics, due to the increased signal-noise ratio from Raman spectrum matrix when compared with that from a single spectrum. The images mapping multiple characteristic peaks can be merged into one using logic-based algorithm, in order to cross-check these images and to further increase the signal-noise ratio. We demonstrate how to capture and identify microplastics, and then zoom down gradually to visualise nanoplastics, in order to avoid the shielding effect of the microplastics to shadow and obscure the nanoplastics. We also carefully compare the advantages and disadvantages of Raman imaging, while giving recommendations for improvement. We validate our approach to capture the microplastics and nanoplastics as particles released when we cut and assemble PVC pipes in our garden. We estimate that, during a cutting process of the PVC pipe, thousands of microplastics in the range of 0.1-5 mm can be released, along with millions of small microplastics in the range of 1-100 μm, and billions of nanoplastics in the range of <1 μm. Overall, Raman imaging can effectively capture microplastics and nanoplastics.

Effectiveness of a multimodal capacity building initiative for upgrading biomedical waste management practices at healthcare facilities in Bangladesh: a 21st century challenge for developing countries

INTRODUCTION

Bio-medical Waste Management (BMWM) has attracted critical attention across the world as its improper management can pose a serious threat for healthcare workers (HCWs), the general population and the environment as well. This study aims to analyse the effectiveness of a multimodal intervention (MMI) in upgrading BMWM practices at healthcare facilities across Bangladesh.

METHODS

This quasi-experimental study, with a pre- and post-test design, was carried out at nine healthcare facilities (five public, three private and one autonomous) over three phases and concluded in 2019. The MMI included various strategies including: i) system change; ii) education and training, iii) visual reminders, iv) monitoring and feedback; v) ensuring sustainability at the study hospitals. The data collected from 2726 HCWs and waste handlers through direct observation was statistically analysed using SPSS 24.

RESULT

Significant improvements were observed in waste segregation practices (rising from 1% to 79%) using colour-coded bins. Use of PPEs during transportation and final management/disposal was also enhanced from 3% to 55%. Compliance to use of standardized methods for collecting and transporting biomedical waste (BMW) increased substantially from 0% to 78% while compliance to standard final management/disposal of BMW practices improved by 39%.

CONCLUSION

Compliance to BMWM practices is very poor in Bangladesh due to a lack of knowledge, manpower and resources. Nevertheless, MMI can be used as a tool to significantly upgrade BMWM practices across healthcare facilities. Such initiatives will assist the government of Bangladesh to achieve sustainable development goal (SDG) 3.3 and universal health coverage by 2030.

A potential role of mesenchymal stem cells derived from human umbilical cord blood in ameliorating psoriasis-like skin lesion in the rats

BACKGROUND

Psoriasis is a common autoimmune inflammatory skin disease, with no clear cause, treated with topical agents and phototherapy to conventional immunosuppressant drugs and biologic agents. Stem cell therapy has showed significant interest in regenerative medicine. The aim of this study was to use mesenchymal stem cell (MSC) therapy compared to the topical application of the standard conventional corticosteroid cream.

MATERIALS AND METHODS

40 male adult albino rats were used, divided into 4 groups, 10 rats each. Group I (control), Group II (Psoriasis-like lesions induced by usage of Aldara cream), Group III (treated with Betamethasone) and Group IV (treated with mesenchymal stem cells). Specimens were stained with Hematoxylin & Eosin, Masson's trichrome, immune-histochemical technique for CD4, CD8 and CD31. Ultra-sections were prepared for transmission electron microscope examination.

RESULTS

MSCs demonstrated efficacy in reduction of disease severity in the form of uniform epidermal thickness covered by a very thin keratin layer. Normally- arranged layers of epidermal layers, with a clear border demarcation was seen between the epidermis and the dermis with apparently intact basement membrane. TEM showed absence of gaps between the tightly connected cells of the basal layer and the resting basement membrane.

CONCLUSIONS

application of MSCs raises hope for developing a new, safe and effective therapy for psoriatic patients, avoiding the side effects of betamethasone.

Effectiveness of social and behavioral change communication intervention to promote the use of 7.1% chlorhexidine for umbilical cord care in hard-to-reach rural Bangladesh: A mixed method study

Background

Developing countries account for 99.0% of the 2.7 million neonatal deaths occurring worldwide each year. Umbilical cord infection contributes greatly to this predicament, but evidence shows that 7.1% chlorhexidine solution (CHX) can substantially reduce the risk of infection. To address this challenge, this study aimed to determine the effect of a social and behavioral change communication (SBCC) intervention on promoting the use of WHO recommended CHX as well as on improving the knowledge, attitude, and practices of rural communities regarding umbilical cord care in hard-to-reach areas of Bangladesh.

Methods

A pretest-posttest quasi-experimental study was conducted in two unions of Jamalpur district during 2017-2019 among 748 pregnant women in their third trimester. The SBCC intervention was implemented through town-hall meetings (n = 3), community meetings (n = 30), and door-to-door meetings (n = 22 223) in Dangdhora union, which served as the intervention group, while Hativanga union was kept as a real-time comparator group. Qualitative data were collected from a total of 200 respondents, where 100 participants were chosen from both intervention and control groups. Statistical analysis was carried out in R and outcomes with P values less than 0.05 at 95% confidence intervals (CIs) were presented.

Results

Following SBCC intervention, significant (P < 0.001) improvements were observed in the intervention group with regards to the primary objective: CHX use increased from 1.07% to 57.80%, while CHX use decreased from 1.6% to 0.0% in the control group. Meaningful improvements were also observed in relation to knowledge (29.0% to 43.0%), attitude (53.0% to 90.0%), and practices (25.0% to 70.0%) of rural communities regarding cord care. Marked improvements were also observed in the intervention group related to understanding causes of cord infections; importance of cord cleanliness; use of antiseptic and other preventive measures; care-seeking behavior; and ensuring hygienic childbirth.

Conclusions

This pioneer study revealed that SBCC interventions led to an increase in CHX use and improved the knowledge, attitude and practices of Bangladeshi communities regarding cord care and cord infection. This indicates that SBCC intervention is indeed an effective and feasible method for reducing infant mortality rates in hard-to-reach populations and achieving SDG goal 3.2.

Antimicrobial resistance situation in animal health of Bangladesh

Antimicrobial resistance (AMR) is a crucial multifactorial and complex global problem and Bangladesh poses a regional and global threat with a high degree of antibiotic resistance. Although the routine application of antimicrobials in the livestock industry has largely contributed to the health and productivity, it correspondingly plays a significant role in the evolution of different pathogenic bacterial strains having multidrug resistance (MDR) properties. Bangladesh is implementing the National Action Plan (NAP) for containing AMR in human, animal, and environment sectors through “One Health” approach where the Department of Livestock Services (DLS) is the mandated body to implement NAP strategies in the animal health sector of the country. This review presents a “snapshot” of the predisposing factors, and current situations of AMR along with the weakness and strength of DLS to contain the problem in animal farming practices in Bangladesh. In the present review, resistance monitoring data and risk assessment identified several direct and/or indirect predisposing factors to be potentially associated with AMR development in the animal health sector of Bangladesh. The predisposing factors are inadequate veterinary healthcare, monitoring and regulatory services, intervention of excessive informal animal health service providers, and farmers’ knowledge gap on drugs, and AMR which have resulted in the misuse and overuse of antibiotics, ultimate in the evolution of antibiotic-resistant bacteria and genes in all types of animal farming settings of Bangladesh. MDR bacteria with extreme resistance against antibiotics recommended to use in both animals and humans have been reported and been being a potential public health hazard in Bangladesh. Execution of extensive AMR surveillance in veterinary practices and awareness-building programs for stakeholders along with the strengthening of the capacity of DLS are recommended for effective containment of AMR emergence and dissemination in the animal health sector of Bangladesh.

Development and serology based efficacy assessment of a trivalent foot-and-mouth disease vaccine

Foot-and-mouth disease (FMD) is a highly contagious disease of cloven-hoofed animals throughout the world. The endemicity of this disease in Bangladesh has been causing high economic loss and an impediment to the full potential surge of livestock industries. In Bangladesh, vaccination using imported or locally produced FMD vaccines is the existing practice of controlling the disease, although vaccine failure cases are very common. Hence, to address the problem, the present study was envisaged to develop an effective FMD vaccine tailored to the circulating indigenous foot-and-mouth disease virus (FMDV) strains. Three local circulating FMDVs O/BAN/TA/Dh-301/2016 (MK088170.1), A/BAN/CH/Sa-304/2016 (MK088171.1) and Asia1/BAN/DH/Sa-318/2018 (MH457186.1) isolates were selected as vaccine strains based on recent epidemiology, genetic and antigenic analyses. These serotype O, A and Asia1 vaccine strains showed strong antigenic relationship (r1 > 0.3) with 100% to 75% of the respective circulating viruses. The candidate viruses were successfully inactivated by 3.0 mM binary ethylenimine within 7-10 h after the onset of inactivation. Extrapolation of inactivation kinetics confirmed < 1 log₁₀ TCID₅₀ in a 10000-liter batch liquid preparation after 24 h inactivation cycle. The inactivated virus particles were significantly (p < 0.05) concentrated and the trivalent vaccine was formulated using 6 µg per dose per serotype antigen payload. The trivalent vaccine was administered in divided doses in different groups of cattle. All doses of the vaccine elicited significantly (p < 0.05) higher levels of antibodies as early as 14-day post-vaccination (dpv) and peak antibody titers were achieved in 28 dpv. The 'full dose' (6.0 µg per dose per serotype) vaccine elicited antibody titers expected to confer protection in 100% cattle of the respective group and maintained such level of antibodies beyond 180 dpv. Thus, the trivalent FMD vaccine prepared with 6.0 µg antigen per dose per serotype of the selected candidate viruses will confer protection against circulating FMDVs of Bangladesh and its neighboring countries.

Evidence of combined effect of amino acid substitutions within G-H and B-C loops of VP1 conferring serological heterogeneity in foot-and-mouth disease virus serotype A

Foot-and-mouth disease virus (FMDV) serotype A exhibits a higher degree of genetic and antigenic diversity resulting in frequent vaccine failure due to serological mismatch between the vaccine and heterologous strains. Currently, knowledge on the molecular basis of antigenic relationships among the FMDVs is limited; nevertheless, intratype antigenic variation due to mutation(s) is widely considered as the main hurdle to appropriate FMD vaccine development. Here, we studied genetic and antigenic variations of four FMDV serotype A isolates, BAN/GA/Sa-197/2013 (BAN-197), BAN/CH/Sa-304/2016 (BAN-304), BAN/DH/Sa-307/2016 (BAN-307) and BAN/DH/Sa-310/2017 (BAN-310) circulating in Bangladesh during 2013-2017. Initially, antigenic relationships (r₁ -values) of the field isolates were evaluated by the two-dimensional microneutralization test (2D-MNT) using the hyperimmune antisera raised in cattle against the vaccine strain, BAN-304. Interesingly, the results showed protective serological cross-reactivity (r₁ -values > 0.4) between the vaccine strain and the field isolates, BAN-307 and BAN-310, except BAN-197 that substantially mismatched (r₁  = 0.129 ± 0.043) with the BAN-304. Although VP1-based phylogeny grouped all the isolates within the same sublineage C (a subgroup of VP3^Δ59 variant) under the lineage A/ASIA/G-VII, strikingly, computational analyses of the viral capsid proteins demonstrated significant deviation at the VP1 G-H loop of BAN-197 from the vaccine strain, while VP(2-4) of both isolates were structurally conserved. To bridge the gap of how the distortion of the G-H loop and consequent antigenic hetergeneity occurred in BAN-197, we performed in silico combinatorial substitutions of the VP1 mutant amino acids (aa) of BAN-197 with the respective residues in BAN-304. Remarkably, our analyses revealed that two substitutions of distantly located aa at B-C (T48I:threonine → isoleucine) and G-H (A143V:alanine → valine) loops, in combination, distorted the VP1 G-H loop. Overall, this work contributes to understanding the molecular basis of antigenic relationships operating in serotype A FMDVs and the selection of suitable vaccine strain(s) for effective prophylaxis of FMD based on VP1-based analyses.

Complete genome sequence of a potential foot-and-mouth disease virus serotype O vaccine strain from Bangladesh

One of the six sublineages of the dominant O/ME-SA/Ind2001 lineage of foot-and-mouth disease virus (FMDV), Ind2001BD1 has already spread throughout 14 countries, including Bangladesh. Here, we report the complete genome sequence of the potential serotype O vaccine strain BAN/TA/Dh-301/2016, which has been shown to provide protection against all the circulating serotype O viruses in Bangladesh. The viral genome is 8,211 nucleotide (nt) long with an open reading frame (ORF) of 6999 nt. The ORF is flanked by a 1098-nt-long 5'-UTR and a 114-nt-long 3'-UTR. Compared to the Indian FMDV serotype O vaccine strain O/India/R2/75 (AF204276), ten mutations were identified in the major antigenic sites of BAN/TA/Dh-301/2016 (MK088170.1).

Screening of commercial meat products from supermarket chains for feline derivatives using SP-PCR-RLFP and lab-on-a-chip

Determination of feline meat in food products is an important issue for social, health, economic and religious concern. Hence this paper documented the application of species specific polymerase chain reaction-restriction fragment length polymorphism (SP-PCR-RFLP) assay targeting a short-fragments (69 bp) of mitochondrial cytochrome b (cytb) gene to screen feline meat in commercial meat products using lab-on-a-chip. The SP-PCR assay proved its specificity theoretically and experimentally while testing with different common animal, aquatic and plant species of DNA. The feline specific (69 bp, 43- and 26-bp) characteristic molecular DNA pattern was observed by SP-PCR and RFLP analysis. For assay performance, it was tested in three different types of commercial dummy meat products such as frankfurters, nuggets and meatballs and digested with AluI-restriction enzyme. The highest sensitivity of the assay using lab-on-a-chip was as low as 0.1 pg or 0.01 % (w/w) in commercial dummy meat products. We have also applied this assay to screen three important commercial meat products of six different brand from six supermarket chains located at three different states of Malaysia. Thus total 378 samples were tested to validate the specificity, sensitivity, stability of the assay and utilization of it for commercial meat product screening.

Emergence of novel lineage of foot-and-mouth disease virus serotype Asia1 BD-18 (G-IX) in Bangladesh

Foot-and-mouth disease virus (FMDV) is a highly evolutionary divergent pathogen causing great economic havoc in many countries. Among its seven existing serotypes, Asia1 is the least divergent with a single topotype both genetically and antigenically. It is reported sporadically in Indian subcontinent and was classified under lineage G-VIII. In 2018, serotype Asia1 re-emerged in Bangladesh after 2013, along with circulation of a novel serotype Asia1 BD-18 (G-IX) lineage. VP1 phylogeny and sequence variation clearly demonstrated the novel strains which was estimated to have at least >5% nucleotide divergence with distinct clade formation. Also, the Bayesian phylogeographic inferences traced back to the origin time of lineage G-IX in early 2017 and a possible origin in Bangladesh. Mutational analysis considering established eight lineages revealed that the virus strains belonged to lineage G-IX contained a unique mutation at 44 position in the B-C loop region of VP1. Inappropriate vaccination and inefficient outbreak surveillance possibly contributed to the current episode of emergence. Therefore, active surveillance and continued vigilance are essential to assess and timely detect the occurrence, extent and distribution of this novel Asia1 strains in Bangladesh and the neighbouring countries.

T4 lysozyme fused with cellulose-binding module for antimicrobial cellulosic wound dressing materials

AIMS

Bacterial infection is a major challenge in wound care. Antimicrobial wound dressings are of great value for treating wound infections. Endolysins are evolving as a new class of antimicrobials with multiple applications. This study describes the production and evaluation of T4 lysozyme (T4Lyz), product of gene e of the T4 bacteriophage, fused with Cellulose Binding Module (CBM) for facile immobilization to cellulosic wound dressing.

METHODS AND RESULTS

Genes encoding T4Lyz-CBM and T4Lyz were cloned and expressed in Escherichia coli and the enzymes were purified by cation exchange chromatography. While the CBM tag did not alter the optimum pH and stability features of T4Lyz, the lytic activity of the fusion protein was lowered. The bactericidal activity of T4Lyz-CBM, determined by viable count plating assay after 1 h incubation with Micrococcus lysodeikticus was 97·5% with 10 μg ml(-1) , and 99·96% and 95% for E. coli and Pseudomonas mendocina, respectively, with 200 μg ml(-1) enzyme. T4Lyz-CBM was immobilized to wound dressing gauze with a capacity of 5·5 μg mg(-1) matrix, whereas the unmodified T4Lyz did not exhibit any binding. The immobilized protein retained its bactericidal activity against Gram-positive and Gram-negative bacteria. Both free and immobilized T4Lyz-CBM, after heat denaturation, retained their bactericidal activities against Gram-negative bacteria only. The immobilized enzyme exhibited higher stability than the free enzyme when stored in dry form or in the presence of polyol stabilizers.

CONCLUSION

Tagging T4Lyz with CBM provides a facile, irreversible binding to cellulosic wound dressing while retaining its activity. This approach may be suitable even for other antimicrobial enzymes and -peptides.

SIGNIFICANCE AND IMPACT OF THE STUDY

The spread of antibiotic resistance requires innovative strategies for discovery and development of effective antimicrobial alternatives. This report presents a novel strategy for producing antimicrobial wound dressing materials.

Re-emergence of circulatory foot-and-mouth disease virus serotypes Asia1 in Bangladesh and VP1 protein heterogeneity with vaccine strain IND 63/72

Foot-and-mouth disease virus (FMDV) serotypes O, A and Asia1 are responsible for significant number of disease outbreaks in Bangladesh; however serotype Asia1 has not been reported in circulation since 1996. The present investigation reports the detection of serotype FMDV Asia1 from local farms in 2012 and 2013 outbreaks. The farms were located in Jessore and Gazipur districts, and one of these farms was under vaccine control programme. Phylogenetic analysis of the complete VP1 gene revealed that FMDV Asia1 is under genetic lineage C having close similarity to the Asia1 sequences of Indian origin. The circulatory genotype Asia1 showed VP1 protein sequence heterogeneity of eight amino acid substitutions within the G-H loop with the vaccine strain [IND 63/72 (AY304994)] used in vaccination programme. ELISA assay revealed that, of seven, only one local field serum sample (cattle vaccinated 38 days earlier) was positive at a titre level of >2.4 (log10) but failed to protect the cattle from infection occurred by the virus. This investigation focused that the eight amino acid substitution in VP1 protein at G-H loop of the locally circulated FMDV serotype Asia1 strain may be a reason for current vaccination failure.

Site selectivity in reactions of hydrazonoyl halides with heterocycles containing amino and thione groups leading to fused heterocycles of potential antimicrobial activity

Reaction of hydrazonoyl halides with 6-(benzylidenamino)-2-thioxo-2,3-dihydro-1H-pyrimidin-4-one and 2,3-diaminoquinazolin-4-one site-selectively afforded 3-substituted-7-(benzylidenamino)-1-phenyl-[1,2,4]triazolo[4,3-a]-pyrimidin-5(1H)-ones, [1,2,4,5]tetrazino[6,1-b]quinazolin-6(4H)-one, and 3-methyl-2-(4-substituted-phenylhydrazo)-[1,2,4]triazino[3,2-b]quinazolin-10-ones in good yields. The structures of the newly synthesized compounds were elucidated by chemical evidence and their IR, 1H, 13C NMR, and MS spectra. Furthermore, some of the products were screened against different strains of bacteria and fungi.

Precipitating factor of seizure in epilepsy: experience in a tertiary care hospital

Patients with epilepsy experience recurrent, unprovoked seizures. In most of the cases seizure occurs spontaneously, but there may be association with various triggers. These triggers may act as seizure precipitating factors (SPFs). This study was done to find out the most common SPFs and their relationship to different types epileptic patients attending a tertiary care hospital in Bangladesh. This cross sectional study was carried out in specialized epilepsy weekly outdoor clinic and Medicine outpatient department (OPD) of Dhaka Medical College Hospital from January 2008 to July 2011, which included 1168 epilepsy patients. All patients attending the clinic were included in the study. Epilepsy syndromes were broadly classified into four categories using the classification system of international league against epilepsy (ILAE) namely, generalized epilepsy (GE), localization related epilepsy (LRE), symptomatic and unclassified. Each patient was evaluated and classified by consultant neurologist. All participants were interviewed through a predesigned close ended questionnaire that included a long list of 30 precipitating factors. Among all the patients 71.5% were male, with most common age group 11-20 years (36.8%). About 62% could indentify at least one precipitator. Excitation (25.2%) was the most common SPF reported by patients followed by emotional stress in 17.7%. Fever precipitated seizure in 16.4% of the subjects. A good number of them (15.5%) noticed that whenever there was sleep deprivation, they had an attack of epilepsy. However, drug withdrawal, playing outside and head trauma were also common among the patients, about 11.7%, 11.3% and 8.4% respectively. Most of the patients can identify their seizure precipitant and clustering of many SPFs suggests a common patho-physiologic mechanism for these triggers. Excitation, sleep deprivation, fever, watching television and head trauma showed a strong association with generalized epilepsy. Patients with seizure disorder should be evaluated for presence of SPFs, because identification of these might help in proper management of epilepsy.

Progress achieved in the elimination of schistosomiasis from the Jazan region of Saudi Arabia

Among the inhabitants of the Jazan region of Saudi Arabia, the prevalence and intensity of Schistosoma haematobium infection have been kept very low for several years, by sustained control efforts. The success of the interventions, which were based on case finding, the treatment of infected individuals, and the chemical and environmental control of freshwater snails, led, in mid-2002, to a strategy to eliminate human infection with S. haematobium from Jazan. The strategy, which was based on regular chemotherapy, snail control (made easier by the focality of transmission in the area) and health education, with screening at primary-healthcare centres, by mobile teams and at diagnostic units, appears to have been successful. No infected snails can now be found in the region and new cases of human infection with S. haematobium are only being detected in border villages (and are attributed to infections beyond the region, in areas where active transmission is still taking place). Total elimination appears possible if the health authorities in neighbouring areas can be persuaded to adopt a similar strategy of control.

Anti-inflammatory and Analgesic Activities of Asteracantha longifolia Nees

The present study was designed to evaluate the analgesic and anti-inflammatory activities of the ethanol extract of whole plant of Asteracantha longifolia Nees (family Acanthaceae) in mice. The analgesic activity was determined for its central and peripheral pharmacological actions using hotplate, formalin induced pain and acetic acid-induced writhing test in mice. Anti inflammatory effects were determined by ear swelling induced by croton oil, xyleneinduced ear edema, leukocyte migration induced by carrageenan, cotton pellet-induced granuloma formation. Tramadol (10 mg/kg) and Ibuprofen (100 mg/kg) were used as reference analgesic agents. The crude ethanol extract showed a significant inhibition of ear swelling caused by croton oil and xylene in mice. The crude extract decreased leukocyte migration induced by carrageenan, also moderately inhibited the weight of granuloma induced by a cotton pellet, as well as the formalin-induced pain. The extract given by p.o. route, produced significant inhibition of abdominal constrictions caused by acetic acid. Moreover, the extract also showed moderate analgesic activity on the hot plate pain threshold in mice. These data demonstrated that the plant may contain bioactive compounds possessing anti-inflammatory and analgesic activities. DOI: http://dx.doi.org/10.3329/bpj.v15i2.12586 Bangladesh Pharmaceutical Journal 15(2): 171-176, 2012

Biological treatment of industrial wastes in a photobioreactor

An algal-bacterial consortium was tested for the treatment from a coke factory. A Chlorella vulgaris strain and a phenol-degrading Alcaligenes sp. were first isolated from the wastewater treatment plant to serve as inocula in the subsequent biodegradation tests. Batch tests were then conducted with samples from the real wastewater or using a synthetic wastewater containing 325 mg phenol/l and 500 mg NH4+/l as target pollutants. Direct biological treatment of the real wastewater was not possible due to the toxicity of organic compounds. Activated carbon adsorption and UV(A-B)-irradiation were efficient in detoxifying the effluent for subsequent biological treatment as inoculation of pretreated samples with the algal-bacterial consortium was followed by complete phenol removal and NH4+ removal of 45%. Complete phenol removal and 33% NH4+ removal were achieved during the fed-batch treatment of artificial wastewater at 6 d hydraulic retention time (HRT). Under continuous feeding at 3.6 d HRT, phenol and NH4+ removal dropped to 58 and 18%, respectively. However, complete phenol removal and 29% NH4+ removal were achieved when 8 g NaHCO3/l was added to the artificial wastewater to enhance algal growth. This study confirms the potential of solar-based industrial wastewater treatment based on solar-based UV pretreatment followed by algal-bacterial biodegradation.

Use of the buccal fat pad in the reconstruction and prosthetic rehabilitation of oncological maxillary defects

We evaluated the effectiveness of the buccal fat pad as a pedicled flap for intraoral reconstruction after partial maxillectomy for neoplastic disease in 24 patients, and subsequently, in providing support for a denture. In all patients the buccal fat pad was covered with a split-skin graft and an acrylic plate. There was complete healing of the buccal fat pad flap within 6 weeks in 18 patients with no major complications, and minimal effects on speech and eating. In six cases there was partial dehiscence of the flap, which healed spontaneously in one patient and was repaired with local flaps in two others. There were no cases of complete breakdown of the flap. Eight patients so far have been rehabilitated with small dentures. In conclusion, the buccal fat pad flap is a simple, quick, and reliable method of reconstruction of small to medium-sized posterior maxillary alveolar defects.

Congenital atresia of the orifice of the submandibular duct: a report of 2 cases and review

Two infants presented with unilateral cystic swellings in the floor of the mouth as a result of imperforate submandibular ducts. This is thought to result from a congenital failure of canalization of the terminal end of the duct. Both cases responded to simple incision and decompression of the fluid-filled duct. Early treatment is important to avoid feeding difficulties and to prevent later complications such as ranula or sialadenitis.

Fractalkine: a novel angiogenic chemokine in rheumatoid arthritis

Angiogenesis is an important aspect of the vasculoproliferation found in the rheumatoid arthritic (RA) pannus. We have previously implicated members of the CXC chemokine family as potent angiogenic mediators in RA. We investigated the possibility that the sole member of the CX(3)C chemokine family, fractalkine (fkn), induces angiogenesis and that fkn might mediate angiogenesis in RA. Recombinant human fkn significantly induced migration of human dermal microvascular endothelial cells (HMVECs), a facet of the angiogenic response, in the pmol/L range in a concentration-dependent manner (P < 0.05). Fkn also induced the formation of significantly more endothelial tubes on Matrigel than did a negative control (P < 0.05). Fkn significantly induced 2.3-fold more blood vessel growth than control in the in vivo Matrigel plug assays (P < 0.05). We identified HMVEC expression of the fkn receptor, CX(3)CR1. Next, we determined if RA synovial fluid (SF)-induced angiogenesis was fkn-dependent. SFs from six RA patients immunodepleted of soluble fkn induced 56% less migration of HMVECs than did sham-depleted RA SFs (P < 0.05). In vivo, immunodepletion of fkn from six RA SFs significantly inhibited their angiogenic activity in Matrigel plug assays (P < 0.05). Immunodepletion of fkn from five RA synovial tissue homogenates inhibited their ability to induce angiogenesis in in vivo Matrigel plug assays (P < 0.05). These results establish a new function for fkn as an angiogenic mediator and suggest that it may mediate angiogenesis in RA.

Clinical and radiological evidence to support superficial parotidectomy as the treatment of choice for chronic parotid sialadenitis: a retrospective study

We present a retrospective series of 23 consecutive parotidectomies, over a 10-year period (1989-1999) for 22 patients with chronic sialadenitis unresponsive to conservative measures. There were 10 male and 12 female patients. Mean age was 52 years (range 12-72), and mean duration of symptoms 4.5 years (range 8 months-30 years). All patients had preoperative sialography and 2 had computed tomography to exclude a neoplasm. A complete superficial parotidectomy with preservation of the main duct was done in all cases. Fifteen patients developed temporary facial nerve weakness postoperatively and 7 developed Frey's syndrome. There were no cases of permanent facial nerve palsy. Nineteen patients reported complete resolution of their symptoms and 3 patients had mild persisting symptoms that did not necessitate any further treatment. Histologically there was evidence of sialadenosis in one case and benign lymphoepithelial lesion in another; the others showed evidence of chronic sialadenitis of varying degrees of severity. Fifteen patients had postoperative sialograms, of which 11 showed evidence of some filling of residual parotid gland parenchyma and in 8 patients there was filling of a normal-looking accessory lobe. In this series, superficial parotidectomy with preservation of the main duct was safe and effective, with minimal long-term complications, for most patients with chronic parotid sialadenitis that was unresponsive to conservative measures and, in some patients, it allowed some preservation of function. The potential damage to the facial nerve and the cosmetic problems associated with a total or near-total parotidectomy were avoided.

Evidence of IL-18 as a novel angiogenic mediator

Angiogenesis, or new blood vessel growth, is a key process in the development of synovial inflammation in rheumatoid arthritis (RA). Integral to this pathologic proliferation are proinflammatory cytokines. We hypothesized a role for IL-18 as an angiogenic mediator in RA. We examined the effect of human IL-18 on human microvascular endothelial cell (HMVEC) migration. IL-18 induced HMVEC migration at 1 nM (p < 0.05). RA synovial fluids potently induced endothelial cell migration, but IL-18 immunodepletion resulted in a 68 +/- 5% decrease in HMVEC migration (p < 0.05). IL-18 appears to act on HMVECs via alpha(v)beta(3) integrin. To test whether IL-18 induced endothelial cell tube formation in vitro, we quantitated the degree of tube formation on Matrigel matrix. IL-18, 1 or 10 nM, resulted in a 77% or 87% increase in tube formation compared with control (p < 0.05). To determine whether IL-18 may be angiogenic in vivo, we implanted IL-18 in Matrigel plugs in mice, and IL-18 at 1 and 10 nM induced angiogenesis (p < 0.05). The angiogenesis observed appears to be independent of the contribution of local TNF-alpha, as evidenced by adding neutralizing anti-TNF-alpha Ab to the Matrigel plugs. In an alternative in vivo model, sponges embedded with IL-18 or control were implanted into mice. IL-18 (10 nM) induced a 4-fold increase in angiogenesis vs the control (p < 0.05). These findings support a novel function for IL-18 as an angiogenic factor in RA and may elucidate a potential therapeutic target for angiogenesis-directed diseases.

Diagnosis of deep vein thrombosis in the leg by using colour coded duplex sonography

BACKGROUND

Deep Vein Thrombosis (DVT) is regarded rare [not readable: see text] Asia. There is no documentation of the incidence of DVT in Pakistan. Clinical diagnosis of Deep Vein Thrombosis is inaccurate. Venography is the most reliable method of diagnosis, but it has several disadvantages. Many non-invasive diagnostic methods have therefore been developed in the past decade. Of these only duplex sonography has comparable accuracy.

METHODS

We studied 100 cases of suspected DVT by using colour coded duplex sonography. We report the results of a prospective study in patients with suspected deep vein thrombosis evaluated by both colour coded Doppler sonography and venography.

CONCLUSION

We conclude that colour coded duplex sonography is a highly accurate, simple, non-invasive method for detecting femoropopliteal thrombosis. Additional venography is not necessary. Its value in diagnosing isolated calf vein thrombosis remains to be established.

Delay in the diagnosis and prognosis of caecal carcinoma--a study of 20 cases

BACKGROUND

Caecum is the dilated part of the right colon situated in the right iliac fossa, therefore the etiology of this cancer is similar to those of the rest of the colon. Caecal carcinoma is more common in developed countries but it is not a rare disease in underdeveloped countries. This is more common in high socio-economic people who use less fibrous and purified diet. With improvement in health education and social status of the people of Pakistan, there is an emerging trend of Westernization in our society. This may increase the incidence of cancer in Pakistan. Carcinoma of caecum is curable disease is diagnosed early and treated. If we are aware of the pathogenesis, etiology, clinical presentation and management of the disease, we can offer a lot to these patients by diagnosing the caecal carcinoma at an earlier stage, this was the aim of this study.

METHODS

20 cases (15 males and 5 females) of Carcinoma of Caecum were studied from January 1997 to December 1999. Out of these six patients presented in emergency ward, 2 as acute appendicitis and 4 as intestinal obstruction. After routine non-specific investigations, our specific investigations included USG abdomen, barium contrast studies and colonoscopy, Barium study and USG remained of primary importance.

RESULTS

Most of the patients were between age 45-65 years, oldest patient being 80 years old and the youngest was of only 30 years. Most of the patients presented as mass in the right iliac fossa and only some patients as intestinal obstruction. Right hemicolectomy with primary ileo-transverse anastomosis was our standard surgical procedure and was done in about 14 cases. But in some cases ileo-transverse by-pass operation was done as the growth was locally advanced. However, only the omental biopsy was taken in the cases where carcinoma was too advanced.

CONCLUSIONS

We think that our sociodemographic factors put a hindrance in detection of this carcinoma at early stages and therefore curative procedures are difficult to bear good results.

IL-4 adenoviral gene therapy reduces inflammation, proinflammatory cytokines, vascularization, and bony destruction in rat adjuvant-induced arthritis

IL-4 is a cytokine with anti-inflammatory properties on activated macrophages. Rheumatoid arthritis, an autoimmune inflammatory disease, is characterized by a paucity of IL-4 and an abundance of synovial macrophage-derived mediators. Herein, the effect of a single injection of adenovirus-producing rat IL-4 (AxCAIL-4) or a control virus with no inserted gene was compared with the effect of PBS injection into rat ankles. Ankles were injected before arthritis onset or at maximal inflammation. Preventatively, AxCAIL-4 reduced adjuvant-induced arthritis (AIA)- and/or AIA/adenoviral-induced ankle inflammation, decreasing articular index scores, ankle circumferences, paw volumes, radiographic scores, mean levels of monocyte chemoattractant protein-1, the number of inflammatory cells, and the number of synovial blood vessels. Therapeutically, AxCAIL-4 also decreased ankle circumferences and paw volumes in comparison with a control virus with no inserted gene and PBS groups. After arthritis onset, mean levels of TNF-alpha, IL-1beta, macrophage inflammatory protein-2, and RANTES were decreased in AxCAIL-4 rat ankle homogenates compared with PBS-treated homogenates. Thus, increased expression of IL-4 via gene therapy administered in a preventative and/or therapeutic manner reduced joint inflammation, synovial cellularity, levels of proinflammatory cytokines, vascularization, and bony destruction in rat AIA, suggesting that a similar treatment in humans may be beneficial.

Treatment with sulfasalazine or sulfapyridine, but not 5-aminosalicyclic acid, inhibits basic fibroblast growth factor-induced endothelial cell chemotaxis

OBJECTIVE

Rheumatoid arthritis (RA) is characterized by leukocyte recruitment and angiogenesis. We investigated the effects of sulfasalazine (SSZ) and its metabolites, sulfapyridine (SP) and 5-aminosalicylic acid (5-ASA), on components of angiogenesis, namely, endothelial cell (EC) chemotaxis and proliferation, as well as on EC chemokine and soluble adhesion molecule expression.

METHODS

SSZ, SP, and 5-ASA were assayed for their effects on basic fibroblast growth factor (bFGF)-induced human dermal microvascular endothelial cell (HMVEC) chemotaxis and proliferation. EC were plated on Matrigel to assess the effect of SSZ on EC tube formation. Enzyme-linked immunosorbent assays were performed to determine changes in HMVEC production of interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), growth-related oncogene alpha (GROalpha), epithelial neutrophil-activating peptide 78 (ENA-78), soluble E-selectin (sE-selectin), and soluble intercellular adhesion molecule 1 (sICAM-1) upon treatment with SSZ or its metabolites.

RESULTS

HMVEC incubated with SSZ or SP exhibited reduced bFGF-induced chemotaxis (59%, [n = 7] and 22%, [n = 3], respectively) (P<0.05). SSZ and SP decreased basal HMVEC proliferation, while 5-ASA increased proliferation (P<0.05; [n = 5]). SSZ decreased bFGF-induced HMVEC proliferation (P<0.05 [n = 5]). SSZ inhibited phorbol 12-myristate 13-acetate-induced HMVEC tube formation (P<0.05; [minimum n = 5]). Tumor necrosis factor alpha-stimulated HMVEC shedding of sICAM-1 was reduced by incubation with either SSZ (19%) or 5-ASA (23%) (P<0.05; [n = 6]). SP inhibited cytokine-stimulated HMVEC expression of IL-8 and MCP-1 (P<0.05; [n = 4]). Neither SSZ nor its metabolites had any effect on HMVEC production of sE-selectin, GROalpha, or ENA-78.

CONCLUSION

These results demonstrate that SSZ and its metabolite SP may affect the pathogenesis of RA by inhibiting EC chemotaxis, proliferation, tube formation, and expression of sICAM-1, IL-8, and MCP-1.

Integration of schistosomiasis-control activities into the primary-health-care system in the Gizan region, Saudi Arabia

A few decades ago, the prevalence of Schistosoma haematobium infection in the human inhabitants of the Gizan region of Saudi Arabia was very high (43%-91%). A vertical programme for the control of the disease, by case finding, treatment of infected individuals and by chemical snail control, was begun in 1974 and led to significant reductions in prevalence in most areas. In 1989 the control activities were gradually integrated into the primary-health-care (PHC) system. Several schools in the area recently participated in the detection of ova (among schoolchildren and neighbouring communities) and organized health-education sessions. The records taken during the vertical and PHC programmes indicate that there were more diagnoses and higher chemotherapy coverage in the latter. The PHC programme has maintained the overall prevalence of infection at an extremely low level (< 1%) and the infection has been completely eradicated in several areas. The participation of schools proved to be particularly useful in terms of population coverage and health education.

Serum LDH and ALP isozyme activities in mice bearing solid Ehrlich carcinoma and/or treated with the maximum tolerated dose (MTD) of aloin

Determination of total LDH and ALP activities and their isozyme patterns in the sera of normal and tumour-bearing animals treated with aloin, a natural anthraquinone with potential antitumour activity, was carried out at 3, 6 and 9 weeks of treatment. Treatment of normal mice with the MTD of aloin (50 mg/Kg b.w.) showed non-significant changes in serum total LDH and ALP activities along with their isozymes throughout the experimental periods. In untreated tumour-bearing animals, serum LDH activity and its isozymes: LDH1-LDH5 showed highly significant increases (192, 32.4, 25.2, 24.7, 29.2 and 30.6%, respectively) after 3 weeks. Highly significant inhibition was recorded in serum total ALP activity and its intestinal and bone isozymes (64, 100 and 56%, respectively), while liver ALP isozyme was increased by 82.3%. Treatment of tumour-bearing mice with the MTD of aloin manifested a significant gradual improvement in both enzyme activities and their isozymes, which were normalized at the end of the experiment (9 weeks), with the exception of intestinal ALP isozyme. All results were reported in comparison to the normal control group.

Falls in the elderly

Finally, we conclude with a reminder that the causes of falls in the elderly are multifactorial and that some of these factors may be summative. Most falls result from interaction of intrinsic and extrinsic (environmental) factors. In the Emergency Department, it is very important to take a detailed history of the circumstances leading to the fall and to perform a thorough physical examination. Every attempt should be made to identify predisposing factors for the fall and for preventive measures to be initiated. These may include geriatric consultation or a home visit to evaluate home environment. There is a great need for additional research in this field. Falls are one of the syndromes common in the elderly that deserve more careful attention and are considered amenable to both primary and secondary prevention measures.